Facility Design

"Lean" (continuous improvement) organizations make use of daily management systems (DMS) that are designed so that problems can be quickly identified, front-line staff are empowered to fix the problems that they can, and problems that the front-line staff cannot fix are escalated and countermeasures created quickly. Key components of a DMS include leadership standard work, visual controls, and a daily accountability process, as well as discipline involving each of these three components.

This white paper from the New York State Department of Health describes operational differences between freestanding emergency department and urgent care centers and gives pros and cons compared with hospital-based emergency departments.

In this presentation, Lou Keller calls on 45 years of experience dealing with every manner of healthcare planning, management, design, control and implementation problem to paint a compelling and entertaining picture, not just of the critical differences between healthcare and all other management systems, but how to use an in-depth understanding and appreciation of those differences to achieve continual and lasting healthcare process improvement.

This paper and presentation at the 2013 SHS Healthcare Systems Process Improvement Conference describes efforts to optimize logistics (transportation of goods and services to and from patient care areas) in a large regional medical center. The basis of the project was the application of simulation modeling to better understand the complexity and interaction of the various logistic activities.

This article in the Perkins+Will Research Journal shows a process modeling approach to defining the size of waiting spaces in a medical office building in the Southeast.

Allocating limited inpatient bed capacity

Many academic hospitals struggle to maintain a mix of patients that satisfies their teaching, research, and financial needs. One such hospital received dispensation from the government to partition its inpatient beds into wings. Each wing is allocated a fixed number of beds and can admit only a fixed set of clinical specialties. This presentation delivered at the 2012 Healthcare Systems Improvement Conference describes how a model was developed to investigate how best to form wings so as to optimize patient mix.

Ergonomics and technology: The future

"By standing for two hours throughout an average workday, you can burn 280 extra calories. In one year, that converts to roughly 20 pounds of weight loss. Results vary depending on body shape and metabolism."

In this presentation at the 2012 Healthcare Systems Improvement Conference, the author addresses the need to increase ergonomics awareness in and out of the workplace by exploring new technology such as tablets, readers and smartphones, their use and place in the work environment as well as the ever-changing workplace including trends in the office and telecommuting.

This recent article from the American Institute of Architects describes progressive improvements to ED design from the author's perspective. Examples of this evolution are provided from University Hospital in Cincinnati, Strong Memorial Hospital, Marymount Hospital, and the University of Pittsburgh Mercy Hospital.

Alleviating crowding and minimizing length of stay continue to be major issues in the emergency department. However, when intake and flow in the ED are examined, it is clear that the issue is multifaceted; it will take a combination of improving proximities, changing the care paradigm, and operational changes to improve the conditions.

IE students at Clemson University have been involved in a multi-year study on patient room headwall design. The study included the School of Nursing at Clemson University and staff and facilities at Spartanburg Regional Healthcare System.